Category Archives: Uncategorized

One of the things I am absolutely bad at is asking for help. My life has often gone flaming down around my ears before it occurs to me to let other people know that I’m having trouble. I’ve therefore spent a lot of time trying to puzzle out the art of seeking assistance, using intellect when the intuition is digging its heels in with full force. It’s one of those irritating things about mental illness that never really goes away–a lot of my energy is spent working against myself, dodging or moving the barriers inside my own head before I ever encounter external resistance.

The hardest and most essential thing for me to do was get help with my mental illness, because while I knew that how I was feeling was somehow “wrong”, I didn’t have much experience feeling any other way and didn’t know how to articulate what was going on. As a teenager I spent years circling the issue with my family doctor, a brisk woman who, while not uncaring, was also no-nonsense. The whole time I was in high school, appointments with her went like this:

Doctor: Any concerns?Me: I feel bad all the time.Doctor: How so?Me: I just feel like crap and I never want to do anythingDoctor: Do you exercise at all?Me: Not really, I feel too tired.Doctor: Exercise every other day, get sunshine, and make sure you’re eating enough fruits and vegetables. That’ll make you feel better.Me: …’Kay?

Having received what seemed like the limit of aid she was willing to extend me I’d go back home, too fatigued and apathetic to get off the couch, until it was time for another checkup and another lecture about exercise, sunshine, and nutrition. My problems may have been exacerbated by acting like a couch potato, but being a couch potato was not my root problem; my root problem was that I was living with unmedicated depression and ADHD. But I didn’t learn to phrase myself in a way my doctor understood until I was nearly finished my bachelor’s degree in psychology, because I didn’t know what information she was looking for.

I used to think that the details were boring and irrelevant to medical professionals, but as it turns out, a few information-laden sentences are as precious gold and silver to a good doctor. This is partly because mental symptoms are totally subjective, so when one person says “sad”, they might mean “kind of bummed out”, and another means “utterly hopeless and lost.”

1. What am I thinking/feeling?

Am I sad? Worried? Scared? Numb? Confused? Absentminded? (A lot of my clients come in and only talk about feeling “good”, “bad”, or “stressed”. Everyone means something different with those words. It’s important for me to find out what those actually mean.)

Do I think, “Boy, I’m a doof” or “I am a worthless piece of shit”? Do I think, “Oh, now I won’t get asked to the dance”, or “No one will ever love me again?” Magnitude counts. I will repeat these lines, verbatim, when reporting my symptoms.

2. When am I thinking/feeling it?

In what situations do I notice these feelings? Am I sitting in front of my favourite cake with all my friends singing “Happy Birthday” and feeling totally empty and alone? Does seeing that the vending machine has sold out of salt and vinegar chips reduce me to tears? If I fumble the change when getting it out of my purse, am I suddenly convinced that the clerk thinks I’m awful? These days, my emotions are a lot more “proportionate” or “normal”, and I report that too: “I got really upset and cried for half an hour when I had a fight with my friend, but I don’t think that’s a symptom of anything but the fight.”

3. How does that manifest in my behaviour?

This one is really hard for me. I actually have a journal tag (“disability:river in egypt”) which I use to retroactively label the entries where I discuss a problem that is clearly (but not to me at the time) the symptom of an underlying problem. So sometimes I get friends and family to help me with this, because they can say, “Hon, you’ve been dragging around the place looking like your dog just died for months now.”

It’s especially hard with anxiety, because symptoms of anxiety for me are all the things I don’t do. When I’m anxious, I don’t return calls or emails, I don’t go to the bank, I don’t start projects, I don’t leave the house, and I try really hard not to remember all the things I’m not doing. It takes some searching to realize “I haven’t started research on my paper because I lost a library book last year and I’m afraid if I ask a librarian for help they’ll… know.” is also a symptom.

But if you just want to tick your way down a list, general categories for this are: Sleep; diet; exercise; energy levels; social life; work/school; hobbies.

So for example, this is me when I’m depressed: I sleep a lot, sleep past my alarm, have trouble getting out of bed, and always feel sleepy or tired; I’m only hungry for really sweet or salty foods and eat a lot of junk; forcing myself to exercise is nearly impossible; I feel too tired and crappy to do anything, and am simultaneously agitated and seek stimulation, usually by playing clicky games on my computer; I skip out on parties, cancel coffee dates, and stop going to group social events; I procrastinate from schoolwork, fall behind on my papers, and miss class; I sometimes start sewing or knitting projects, but lack the will to work on them for more than 20 minutes at a time or finish them when it’s tedious.

4. How long has this been happening and how often does this happen?

Numbers can be glorious. The first time my doctor took my depression really seriously was when I said, “I didn’t get out of bed and skipped my 11am class all three days I had it this week.” It’s like I was suddenly talking a language she understood.

This means you can say, “Once or twice a month, I get so anxious it feels like I’m going to have a heart attack,” or “The last day I didn’t think about what a worthless person I am was in 1998.” Or, you know, more complicated things: “Most of the time I’m okay, but a couple times a week…” “Whenever we visit friends.” “Ever since the car accident in April.”

Conclusion

This all does rely, sadly, on having a sense of what is or isn’t “normal”. (I used to be kind of incredulous at the thought that the vast majority of the population did not feel sad and worried all the time. I couldn’t imagine what it would be like to live like that.) But if you get a sense of what’s bugging you, you can clearly articulate it in terms that the doctor can easily parse. Many doctors are busy people, who haven’t scheduled a whole hour to gently pry apart the meaning of “I feel bad”.

So what a younger me might have said to my doctor was: “I feel sad all the time and really worthless. I have to force myself to do schoolwork, even when I really love it. My homework is always late. I feel so tired and crappy I don’t even go out and ride the horses or hang out with my friends; I sit alone most days at lunch by choice. When I went to a dance last week I spent the whole time standing against the wall thinking, ‘This is useless, no one will ever love me.’ I’ve felt this way for years. The last time I remember not feeling this way, I was six.”

Being a counsellor with no clients sucks. I’ve been working at the foster home for five months now, making sandwiches and sitting through meltdowns for little more than minimum wage. It’s wearying and dispiriting and making me question my decision to live in this beautiful city, which I love, and which is positively oversaturated with mental health professionals. I even had one afternoon where I was positively convinced I wanted to move home to my rural, frozen, politically conservative city of origin, which unfortunately has rather more job openings (and better licensing laws). It passed, but still: it happened.

I miss being a therapist. I miss not worrying every two weeks about whether my bank account will go into overdraft. I miss being able to go home at the end of eight hours and pet my cat.

(Cat is a separate-but-related concern. My beloved cat died in March, at fifteen years old. I decided not to get another cat until I knew I could afford it and whatever veterinary expenses it might incur, since not being able to afford treatment for a sick pet is a special hell with which I’ve become well acquainted. Time has gone on, my money situation hasn’t gotten better, and two weeks ago I bought myself a teddy bear because I so desperately needed something to cuddle and I couldn’t keep telling myself a cat would happen “soon”.)

I keep forgetting that it’s July, the height of summer, despite how taxing the heat is. It feels like some harder, drier season.

So it’s times like this I revisit my favourite stories, the ones about people who do the right and necessary thing despite the cost. I watch Call the Midwife and Oranges and Sunshine (which magnify heartbreak between them, as the stories echo back and forth), and Short Term 12 and Citizen X. I try to find something deeper to draw from.

I go back to the poem I discovered in undergraduate, when I chafed at years of classes and no meaningful work to do, and try to drink my fill again when I have work, but it’s not my own.

To Be of Useby Marge Piercy

The people I love the bestjump into work head firstwithout dallying in the shallowsand swim off with sure strokes almost out of sight.They seem to become natives of that element,the black sleek heads of sealsbouncing like half submerged balls.

I love people who harness themselves, an ox to a heavy cart,who pull like water buffalo, with massive patience,who strain in the mud and the muck to move things forward,who do what has to be done, again and again.

I want to be with people who submergein the task, who go into the fields to harvestand work in a row and pass the bags along,who stand in the line and haul in their places,who are not parlor generals and field desertersbut move in a common rhythmwhen the food must come in or the fire be put out.

The work of the world is common as mud.Botched, it smears the hands, crumbles to dust.But the thing worth doing well donehas a shape that satisfies, clean and evident.Greek amphoras for wine or oil,Hopi vases that held corn, are put in museumsbut you know they were made to be used.The pitcher cries for water to carryand a person for work that is real.

Talking with a friend on being pressured to “make peace” with her hugely toxic parents, I found myself saying something I want to remember for future use.

You ARE making peace with them. The kind of peace that comes from having a border fenced with barbed wire and patrolled by armed peacekeeping troops from a neutral third party.

For some of us, “making peace” means coming together into emotional closeness. For others, it means a lifelong process of negotiating an end to the hostilities.

(In other news, I’ll be at one foster home or another for 72 hours straight this week, and then I have a six-hour training on nonviolent conflict intervention, which is like the martial art of the helping professions because the goal is to cause the least amount of harm possible. I’m considering laying in a stock of meat pies and chocolate chip cookie dough for myself when I get off work on Thursday, because that level of stress and exaustion demands easy-to-procure carbs.)

I thought I was a bit snippy before, but then I got some really insightful comments to my post on people “outwitting” their therapists and now I would like to bite something (not my commenters!), as people contributed a lot of great ideas about how clients get set up in adversarial relationships with their therapists.

I have this dangerous habit of naivete that’s hard to break, which is: I forget about bad therapy and people who use therapy badly. I like to relegate it to this separate place in my head and separate it from my vocation. We may have come pretty far, but psychotherapy’s roots still go back to deeply toxic structures of institutionalization and social control.

I think a really common thread to the stories I get treated to was that the person was brought into therapy as a child, often for being “weird” or “odd”. And a lot of child therapists, bless their hearts (she says through gritted teeth) actually do take it as their mission to take “odd” children and turn them into normal, happy, healthy children. And sadly, a lot of dominant discourses say that normalcy is the path to health and happiness. “If you stopped monologuing about Pokemon, then you could make friends and have a good social life!”

And, well, these conversations usually take place while at least one of us is in costume. We’re geeks. We’re odd children who grew into odd adults. We monologue at each other. “Normal” is the shoe that doesn’t fit.

Also, I did some work in my last practicum as a child therapist, and what really got to me was that all the parents assumed at first that taking your kid to therapy was like dropping your car off for an oil change. You go and someone takes the kid away, and then brings them back 45 minutes later a little bit more fixed! “Here’s your counsellor, Timmy. She’s here to make you less of a freak. I’ll be reading a magazine in the waiting room.”

The nice way to talk to the parents I worked with was, “I’m a stranger who sees your child once a week. I’m good for what I’m worth, but I am nowhere near as important as you are. You’re with him every day; you’re one of the foundations of his world. If I do work with him, unless it’s being supported by things that change at home, it won’t be nearly as effective.”

(That was also the practicum that got me a case of, “Your child’s doing amazingly well considering the circumstances, but holy hell YOU need some psychiatric services STAT. Let me write up a list of symptoms to take to your GP, and show you how to dial 211. Also: HOW many social workers, law enforcement officers, and doctors signed off on your case without noticing this? Jesus, Mary, and Joseph.”)

I love knowing that people like Social Jerk are slogging it out in the trenches of Child Welfare work, because when I think too much about the way our society practically enshrines a parent’s sense of proprietary ownership over their child I kind of want to swell up into a giant beast of rage and start lighting things on fire.

I travel in pretty geeky circles–renfaire, science fiction conventions, that kind of thing. Over my life I’ve seen geekdom really blossoming from a weird niche interest into something more socially recognized and accepted, so it carries less of a stigma than I think it used to. However, it’s still very much full of people who grew up feeling different and weird and rejected by the communities they grew up in. (*raises hand*)

Some of the people I find it hardest to get along with are people who reacted to those early experiences by becoming defensive, angry, and a little bit paranoid that the world is fundamentally stacked against them. Which, okay, I understand! It usually comes from a super valid place. But what I have trouble with is when this is the universal attitude someone goes through the world with. Everything is an attack, and it’s specifically targeted at them. Unfair bosses, unkind lovers, uncooperative trains, hot coffee, cold butter pats–you name it. And nobody, nobody has it worse than them, ever.

No, that’s not what I have a problem with. It’s what living that way does to a person’s relationships. If you view the entire world as a hostile and threatening place, it becomes impossible to trust that some people might have genuinely good intentions and the capability to carry them out. If being the noblest victim who ever was victimized is core to who you are, you lose the ability to be empathetic or compassionate to other people who are struggling (unless they are exactly like you somehow). There’s no space for gentleness or authentic sharing of self. Everything becomes so harsh and instantly judged.

(Then there is also the fact that when you perceive yourself as helpless, you lose touch with your ability to wield power over other people. Not that you lose the power–though depending on the circumstance you may or may not get any; you just lose your awareness of when you have it or how you’re using it, and you’ve abdicated responsibility for decisions regarding it. This can make people who think of themselves as powerless infinitely more dangerous than those who accept what power they do or don’t have at the moment.)

Anyway, this came to mind when I was reminded of one of the reactions I’m least fond of, when I tell people what I do. (If you meet a therapist socially, and you think that you are being witty and unique by joking “I should be your client!” or “You should write an article about me!”–you really, really aren’t.) And that is the wary, defensive people who say, “I went to a therapist once, but I figured out everything she wanted, so I outwitted her and never went back.”

Trying to outwit your therapist is like putting on a raincoat before you get in the shower, and then bragging that you didn’t get wet. It’s essentially missing the point. The point of therapy is to have a person who is, for the time you are together, entirely dedicated to hearing what you have to say and helping you with your problems. The therapist’s conclusions or observations are ultimately irrelevant compared to what that process is like for you. It’s those actual butt-in-chair hours talking and trying to let someone else understand you that heal. There are often clients whose problems I can call ahead of time from one session in, but it would be absolutely no help at all if I just dumped the cerebral knowledge, “You’re never going to be as good at your work as you want to be, because it’s really a substitute for feeling like a worthy person; eventually you have to embrace that and start getting angry at your parents for neglecting you all your life” on them. It would be the opposite of helpful. They need to process it a little bit at a time, doing most of the work themselves.

So if you’re going to walk in and be entirely closed to that process of forming a bond of trust based on empathy and understanding, uh, congratulations; you have sabotaged your own therapy. What, you realized we therapists want to talk to you about difficult emotions and vulnerable areas and this process might be hard for you? OH NOES OUR SECRETS HAVE BEEN REVEALED. (Except therapy works even if you know how it works, because life’s a bitch that way.)

I do my best, with these little chitchat exchanges, not to let a smart remark fly out of my mouth. Oh, you outwitted your therapist? “I’m sorry you didn’t have a good experience,” I say politely, and go check out the vendor booths. Not to mention, when I get drawn into debates about psychology and sociology with this kind of nerd, I tend to pull a Cordelia Naismith Vorkosigan and not quite realize that I’ve just emotionally gutted my conversational partner until we both become aware of a pool of blood spreading on the floor. (I self-sequester from Nice Guys™ these days.)

I still haven’t found a right imaginary occupation–you know, when you lie and say that you’re an accountant just to stop having the super awkward conversations about your job. (Do accountants have these? Must ask.)

I’m having difficulty dealing with the idea of “positive” and “negative” coping strategies. It’s both an abstract and a concrete problem for me right now.

This is another manifestation of that thing where I don’t like absolutes to the point where I know it drives some people up the wall. I’m shaped enough by culture to acknowledge dichotomies as a roughly functional paradigm, but I have a hard time polarizing them. “Am I a bad person for doing this?” a friend asks, and my first reaction is, “Well, ‘bad person’ isn’t really a thing. You made a hard choice but it doesn’t affect who you fundamentally are.” WHICH IS NOT HELPFUL I KNOW, so I sit on it when I can.

But I have a hard time not seeing the word like this: every cloud has a silver lining. Sometimes an act of unequivocal good can have negative consequences. Any decent medicine in the wrong dose is a poison. Every tool is a weapon if you hold it right. Sometimes violence can be an act of peace. The image that comes to mind when I think about this tendency in myself is Janus, the ancient Roman god of doorways, who looked both ahead and behind. My role in life is so often performing that flip of symbolic inversion, changing good for bad and shadow for light, and inviting people across thresholds of transition. It’s always more complicated. It’s time to change now.

(Everyone who can guess my MBTI type now wins a warm sense of self-satisfaction.)

At my great-aunt’s funeral reception a few years ago we got to swapping stories with cousins we don’t see that often. My paternal grandmother was one of… oh, let’s keep this vaguely anonymous; ten or twelve children. And she’s one of, let’s say, half-a-dozen girls. I think I have more than fifty first and second cousins in that family alone. Anyway. We got talking. One of the things we got talking about was our great-grandfather’s glass eye, which everyone involved at the very least agreed he had.

Second cousin A heard that he’d lost his eye in the Great War.

Second cousin B always thought it was when he’d worked in a coal mine, and a chip of coal flew up into his face.

Uncle C laughed and confessed that he’d heard once that he injured it in a fight when he was drunk.

Yes, Aunt D added, quick to top that one; the fight had been with his wife, when they were both drunk.

Surely not! some of the cousins cried, while others laughed and muttered, No wonder they keep telling stories to cover it up.

“Not that you’ll ever know for sure,” Uncle E said, taking a sip of his beer. “Those sisters, they’re tight and thick as thieves, and they’re taking that secret to their graves.”

The phrase code of silence comes to mind a lot when thinking about that family. But it’s not actually a code of silence; it’s a code of smiling and laughter. My grandmother and her sisters may tell a different story from each to each, but one thing their stories relentlessly insist on is that Everything Was Happy We’re All Fine Here How Are You, Pay No Attention to the Man Behind the Curtain.

Now, here’s something I’m not going to run by a couple hundred of my closest relatives, but I’m still sure of: something stinks here. I’m a therapist; we’re basically scenthounds for secrets and covert violence. And if you told me that story like it was about somebody else’s family the first thing I would ask is, what are those girls covering up?

This is what it looks like from the outside when a family is committed to hiding something it’s ashamed about. What is it? I don’t know. I already have hints of alcoholism and violence, but I don’t know what else could be there. I’ve seen other families like this that hid everything from chronic money problems where the family tries not to let on that they’re constantly on the verge of bankruptcy, to chronic incest where everybody knows who’s being molested and who’s doing the molesting and a lot of them have grown from the first to the second. It could be anything and I don’t know, and as my grandmother and great-aunts have begun develop dementia and die, I may not ever know.

But okay, you know what? If you are willing to posit a Dark Family Secret, this was a pretty okay way of dealing with it. My grandmother and her sisters chose to approach life with cheerful optimism. Humour and levity are coping mechanisms in our family. I grew up in a close family that was consistently there for me, with grandparents who unquestionably loved me. There is a lot of good here.

The shitty thing about coping mechanisms is that when you start using them, you don’t usually know what their cost will be, and you don’t always know when to stop using them.

This memory has been haunting me since my dad’s breakdown begins. It’s of my grandmother telling a story she told several times over my life (she has a set repertoire she seldom deviates from). I can picture the room we’re in, the last time she told it maybe five years ago; I’m standing by the door, watching her tell it to someone new.

It’s the story that demonstrates how no one my father’s family is musical. Or maybe it demonstrates why, since telling the story perpetuates it. The story is about my dad when he was in grade school. At school, they were having some kind of concert or pageant or something, and the day they handed out parts, Dad marched home proudly and announced, “We got our parts, and I’m one of the Singers!” My grandmother congratulated him, but thought, But no one in our family can sing! Oh no!

Well, my father went off to the first rehearsal for this show, and my grandmother waited to see what would happen; and when it was over he marched proudly home again and announced, “I’ve been moved. Now I’m one of the Speakers!”

That’s the end of the joke. Everyone laughs here.

When I was a child then there would be a footnote, because I could sing, and my parents paid for singing lessons when I was a child. So the story changed to Nobody in Our Family Can Sing Except Lis. So when I was growing up, I was totally distracted from the story itself, because I was already anticipating that sweet delicious hit of praise at the end. I vaguely connected this to the fact that my father burst into trills of song occasionally, but deliberately did it off-key, with a self-mocking air. His voice, when he uses it, is a deep, resonant thing.

So what absolutely slays me about this story when I remember it now is the casual cruelty of it. It’s also one of the only stories my grandmother ever tells about my father’s boyhood—I have the vague sense that there are others, but I can’t remember them. So for the amusement of friends, family, and new acquaintances, she tells this charming little tale of the time her son felt proud of something he totally sucked at, and how funny it was when he didn’t realize he’d been told that he wasn’t good enough.

It’s a story my dad has had to sit through retellings of for basically his entire life. Not only do I not wonder at all that singing for him is an area of deep shame and thwarted longing, but I especially don’t wonder that he has trouble reaching for “feeling words”. Where was the space for him to express what he felt, when one of the fundamental narratives of his childhood was that his feelings and thoughts about himself were wrong, when he thought he was being accepted by the community he was really being rejected, and he was destined to be ridiculed for that?

Ever since Dad and I broke our own pact of silence last winter, I’ve been able to see things about him in a new light, and suddenly the fabric of my childhood is littered with landmines like that.

Sooo it’s no fucking wonder Dad keeps winding up back in hospital, since he’s exploring his childhood in new! exciting! ways! Fortunately, he’s in an intensive outpatient program.

None of this keeps me from being disappointed that Dad’s siblings are going fucking ballistic over his failures as a son/brother right now. I mean, I expected them to react badly somehow, just based on the family systems principle that when one person in a rigid system breaks out of their role, everyone else is going to work extra hard to force them back into it; but I’m still disappointed with their timing and execution.

We are a long long way from being the kind of family that can talk about hard things without ripping each other to shreds. My nuclear family is learning how to be, and we all have the healing ribbons of skin to prove it. My extended family… not so much. Not yet.

It’s been exciting to really get this blog up and running. I wish I was more chipper, but it’s been a tiring week thanks to work. I keep pulling extra shifts, which are nice financially but still a bit draining.

This week I had my first session with a new therapist. I moved to a new city in the spring, so I’ve had to find somebody new and get acquainted all over again. Once we get settled in, I think it’ll help to have someone to work through all the upheavals in my family with.

People tend to act surprised that therapists see other therapists as clients. I think part of it is still because there’s a stigma against mental illness still built into the profession–there are Them, who are mentally ill and lack insight; and then there is Us, who are the sane healthy fixer people who have all the answers. There’s this idea that if you just had all the answers, if you just knew all the right things, you wouldn’t need therapy, because you’d just figure it all out on your own. Or more generously, the mechanisms for fixing it all would already be built into your life. This is a myth and not based in reality, but it’s a tempting myth, especially among the shrinks that are trying to live it. Find all the answers, and never more experience pain, confusion, and loss!

And there certainly is pressure on mental health practitioners to keep their mouths shut about their own personal experiences. Francine Shapiro was open about EMDR’s genesis in her own personal thought processes, and I’ve never been able to convince myself that the skepticism that met one of the most revolutionary and effective treatments for PTSD to date was entirely separate from that fact. Other practitioners and researchers have tended to wait until they’re established in the field before speaking out, like Kay Redfield Jamison and Marsha Linehan, even though it’s pretty obvious to me that their intuitive leaps and profound understanding are due in large part to personal introspection. (A thought for later days: the field of psychology has a great unpaid debt to mentally ill women, and will one day have to pay for its emphasis on detached objectivity)

So anyway. The bitch of psychotherapy is that it works even if you know how it works. It’s not actually about having all the answers; it’s about the experience of telling someone what you’re thinking and hearing what they have to say. Unwinding far enough to hear yourself say the words out loud, or letting the tears uncork. A lot of the time the only thing your therapist can do is sit there, but they can do that very well. I’m not convinced we will always need psychotherapists, but as a Catholic I’ve been to Confession enough to realize that cultures keep finding a way to nurture unique, socially-sanctioned, emotionally intimate healing relationships. Some still have huge issues with doing it particularily well (like I said, I’ve been to enough Confession to know) but all of them find a way.

So some people try to duck out on therapy when they really need it because of mental health stigma, which is not my deal, and some because they want to go it alone, which I’ll argue with at least some merit isn’t me either. I, meanwhile, try to squirm my way out of going to see a therapist because it is screamingly uncomfortable for me when someone else knows more about me than I do. SADLY, a willingness to let go of my control over how people view me is also an essential requirement for intimacy with other people, so I make myself do it rather in the same way I make myself eat vegetables. I like holding all the cards and knowing all the answers, but doing it all the time isn’t good for me. (There is also, not that I like to remember it when I’m being grumpy, something absolutely delightful in being known, recognized, and understood far beyond what you ever anticipated; but in my bad moods I try to forget that wholesale.)

Being mentally ill is tedious in a way I can’t quite describe. I know how to be healthy; I know what it’s like when I’m healthy; but damned if I can just make myself do it sometimes.